The researchers pointed to the findings as suggestive that increasing access to local physical activity facilities and, possibly, reducing access to fast food close to residential areas could reduce overweight and obesity at the population level. However, an accompanying editorial cautioned against overinterpreting the observational data: "Unfortunately, in addition to familiar concerns related to research of this type, the authors' use of ready-made UKBUMP [U.K. Biobank Urban Morphometric Platform] metrics raises questions for their analysis of fast-food outlets, and might have led to a false negative -- i.e., the incorrect indication of little or no association with adiposity."

High-dose stereotactic radiation therapy focused on the heart as a noninvasive form of ablation resulted in a 99.9% reduction of ventricular tachycardia episodes in a five-patient case series, as recorded by implantable cardioverter-defibrillators (ICDs).

There were no pericardial effusions, left ventricular ejection fraction reductions, adverse effects on the ICD system or lead performance, pulmonary symptoms, or complications during treatment or the index hospitalization, although there were some mild transient inflammatory changes in the adjacent lung. One patient died of a stroke at 3 weeks, although of unknown relation to the procedure.

The researchers concluded in the New England Journal of Medicine paper that "if a noninvasive approach to ablation of ventricular tachycardia is shown to be safe and effective, it would be a potentially important therapeutic advance."

Two randomized trials reported at the American Society of Hematology meeting in Atlanta found direct oral anticoagulants (DOACs) to be at least as good as low molecular weight heparin (LMWH) for preventing venous thromboembolism (VTE) in people with cancer.

In the Hokusai-VTE Cancer trial, edoxaban (Savaysa) was equivalent to dalteparin (Fragmin) for first recurrent VTE or major bleeding event at 12 months (12.8% versus 13.5%, HR 0.97, 95% CI 0.70 to 1.36). However, major bleeding occurred more often with edoxaban.

In the Select-d trial, rivaroxaban (Xarelto) had a lower incidence of VTE at 6 months than did dalteparin (4% versus 11%). Major bleeding episodes occurred in 3% to 4% of patients in each treatment arm. Clinically relevant nonmajor bleeding occurred more often with rivaroxaban (13% versus 2%).

The results together make a case for DOACs as an alternative to LWMH for prevention of cancer-related VTE, said the principal investigator of the Hokusai trial, Gary Raskob, PhD, of the University of Oklahoma School of Public Health in Oklahoma City.

"The results of these trials are more similar than different. I think the best conclusion would be that we now have two trials with consistent results that we can probably, in most cases, replace a low molecular weight heparin with an oral direct anticoagulant."

The first generation of troponin tests to be considered high sensitivity was approved early in 2017, and now the first observational study of its use in U.S. emergency departments has affirmed accuracy.

Acute MI could be ruled out with a negative predictive value of 99.3% if high sensitivity-troponin tests fell below the cutoff of 19 ng/L -- the 99th percentile in the U.S., consistent with the Third Universal Definition of AMI -- upon measurement at presentation and at hour 3.

Levels below 6 ng/L at either time point carried a negative predictive value of 99.4%, the investigators reported online in JAMA Cardiology. Either way, the test identified patients with a less than 1% risk for MI, urgent revascularization, or death occurring within 30 days.

"If the findings ... hold true on further validation, implementation of hsTn [high-sensitivity troponin] tests could be the game changer we have been waiting for," an accompanying commentary noted. "It will provide clinicians with objective data to support early discharge of patients who are low risk ... However, we need to proceed cautiously."

A systematic review in Hypertension found that only 61% of studies were able to validate a ambulatory, home, or clinic upper arm blood pressure measurement device in pregnant women against a mercury sphygmomanometer. Only a third of those successful studies didn't have a protocol violation.

"Given the implications of inaccurate BP measurement in pregnant women, healthcare providers should be aware of and try to use the BP measurement devices which have been properly validated in this population," the researchers concluded.

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